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Onset and Rate of Cognitive Change Before Dementia Diagnosis: Findings From Two Swedish Population-Based Longitudinal Studies

Published online by Cambridge University Press:  17 November 2010

Valgeir Thorvaldsson
Affiliation:
Department of Psychology, University of Gothenburg, Gothenburg, Sweden
Stuart W. S. MacDonald
Affiliation:
Aging Research Center, Karolinska Institute, Stockholm, Sweden Department of Psychology, University of Victoria, Victoria, British Colombia, Canada
Laura Fratiglioni
Affiliation:
Aging Research Center, Karolinska Institute, Stockholm, Sweden
Bengt Winblad
Affiliation:
Aging Research Center, Karolinska Institute, Stockholm, Sweden
Miia Kivipelto
Affiliation:
Aging Research Center, Karolinska Institute, Stockholm, Sweden
Erika Jonsson Laukka
Affiliation:
Aging Research Center, Karolinska Institute, Stockholm, Sweden
Ingmar Skoog
Affiliation:
Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Simona Sacuiu
Affiliation:
Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Xinxin Guo
Affiliation:
Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Svante Östling
Affiliation:
Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Anne Börjesson-Hanson
Affiliation:
Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Deborah Gustafson
Affiliation:
Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Boo Johansson
Affiliation:
Department of Psychology, University of Gothenburg, Gothenburg, Sweden
Lars Bäckman
Affiliation:
Aging Research Center, Karolinska Institute, Stockholm, Sweden
Corresponding

Abstract

We used data from two population-based longitudinal studies to estimate time of onset and rate of accelerated decline across cognitive domains before dementia diagnosis. The H70 includes an age-homogeneous sample (127 cases and 255 non-cases) initially assessed at age 70 with 12 follow-ups over 30 years. The Kungsholmen Project (KP) includes an age-heterogeneous sample (279 cases and 562 non-cases), with an average age of 82 years at initial assessment, and 4 follow-ups spanning 13 years. We fit mixed linear models to the data and determined placement of change points by a profile likelihood method. Results demonstrated onset of accelerated decline for fluid (speed, memory) versus crystallized (verbal, clock reading) abilities occurring approximately 10 and 5 years before diagnosis, respectively. Although decline before change points was greater for fluid abilities, acceleration was more pronounced for crystallized abilities after the change points. This suggests that onset and rate of acceleration vary systematically along the fluid-crystallized ability continuum. There is early onset in fluid abilities, but these changes are difficult to detect due to substantial age-related decline. Onset occurred later and acceleration was greater in crystallized abilities, suggesting that those markers may provide more valid identification of cases in later stages of the prodromal phase. (JINS, 2011, 17, 000–000)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2010

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